What are the benefits and potential interactions of chamomile tea in adults, particularly those with allergies, pregnancy, or taking medications like blood thinners?

Benefits of Chamomile Tea

Chamomile tea is generally safe for most adults and offers modest benefits for anxiety reduction and oral health, but should be avoided in individuals with allergies to plants in the Asteraceae/daisy family, and used cautiously in those taking blood thinners due to potential antiplatelet effects.

Primary Health Benefits

Anxiety and Mood Effects

• Chamomile demonstrates modest but significant anxiety reduction in clinical trials, with active compounds like apigenin modulating neurotransmitter pathways and the hypothalamic-pituitary-adrenocortical axis 1.
• The Society for Perioperative Assessment and Quality Improvement (SPAQI) consensus statement notes that randomized controlled trials found modest but significant reductions in anxiety with chamomile extract, with no CNS effects that would interfere with anesthesia 1.
• A 2024 systematic review of 10 clinical trials concluded that 9 out of 10 studies demonstrated chamomile's effectiveness in reducing anxiety 2.

Anti-inflammatory and Antioxidant Properties

• Chamomile's terpenoids and flavonoids provide anti-inflammatory, analgesic, and antioxidant effects that are FDA-recognized as generally safe 1.
• These properties make it useful for hay fever, inflammation, muscle spasms, menstrual disorders, ulcers, wounds, gastrointestinal disorders, rheumatic pain, and hemorrhoids 1, 3.

Oral Health Benefits

• Chamomile mouthwash (1%) reduces plaque index and bleeding on probing comparable to chlorhexidine in orthodontic patients with gingivitis, based on a randomized placebo-controlled trial of 30 patients 1.
• Chamomile mouth rinse helps control pain and burning sensation in aphthous stomatitis patients and shows promise for oral mucositis treatment 1.

Sleep Effects

• Evidence for sleep benefits is mixed and inconclusive—a 2011 randomized controlled trial in 34 chronic insomnia patients showed no significant differences in total sleep time, sleep efficiency, or sleep latency compared to placebo 4.
• Chamomile showed only modest advantages in daytime functioning that did not reach statistical significance 4.

Critical Safety Considerations

Allergy Risk

• A small percentage of people develop allergic reactions to chamomile, primarily contact allergies, particularly those with sensitivities to other plants in the Asteraceae/Compositae (daisy) family 1, 5.
• This is the most important contraindication to screen for before recommending chamomile.

Antiplatelet Effects and Blood Thinner Interactions

• Chamomile has significant antiplatelet activity in vitro and anticoagulant properties 5.
• While the SPAQI consensus recommends chamomile can be "considered continuing" perioperatively (unlike ginger, ginkgo, and other herbs that must be held 2 weeks before surgery), this reflects its relatively lower risk profile 1.
• Exercise caution in patients taking warfarin or other anticoagulants—while not explicitly listed in warfarin dietary interaction guidelines, the antiplatelet effects warrant monitoring 6.
• The American Cancer Society notes that ginger (a related herb) has antiplatelet activity and prolongs bleeding time, suggesting similar caution applies to chamomile in high-risk bleeding scenarios 1.

Pregnancy Considerations

• The evidence provided does not specifically address pregnancy safety, but given chamomile's traditional use for menstrual disorders and its bioactive compounds, pregnant women should consult their healthcare provider before regular consumption 1, 3.

Practical Recommendations

Who Should Use Chamomile

• Adults seeking mild anxiety reduction without prescription medications 2.
• Patients with gingivitis or oral inflammation as an adjunct to standard oral hygiene 1.
• Individuals with gastrointestinal discomfort or inflammatory conditions 1, 3.

Who Should Avoid or Use Cautiously

• Avoid completely: Individuals with known allergies to Asteraceae/daisy family plants 1, 5.
• Use with caution and medical supervision: Patients on warfarin, antiplatelet drugs, or with bleeding disorders 1, 5.
• Consult provider: Pregnant or breastfeeding women (insufficient evidence in provided literature).

Dosing Based on Evidence

• For anxiety: 270 mg standardized extract twice daily 4.
• For oral health: 1% chamomile mouthwash twice daily 1.
• As beverage: Millions consume chamomile tea daily without adverse effects, suggesting typical tea consumption (1-2 cups daily) is generally safe for most adults 1, 3.

Common Pitfalls to Avoid

• Do not assume chamomile is effective for insomnia—the evidence does not support this popular belief 4.
• Do not overlook allergy screening—always ask about daisy/ragweed allergies before recommending 1, 5.
• Do not ignore medication interactions—specifically assess anticoagulant use 1, 5.
• Do not recommend as monotherapy for anxiety disorders—effects are modest and should complement, not replace, evidence-based treatments 2.